Individual
DR. CHARLES ALLEN WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD., DAAPM
Contact information
Practice address
707 E WOOD ST, PARIS, TN 38242-4221
(731) 644-0144
(731) 644-0887
Mailing address
707 E WOOD ST, PARIS, TN 38242-4221
(731) 644-0144
(731) 644-0887
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD0000017178
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010065755
RAILROAD MEDICARE PROVIDE
TN
01
—
0503996
CIGNA PROVIDER NUMBER
TN
01
—
3015336
BLUE CROSS PROVIDER NUMBE
TN
01
—
44D0944207
CLIA NUMBER
TN
01
—
5004078
TLC PROVIDER NUMBER
TN
01
—
5785037
AETNA PROVIDER NUMBER
TN
01
—
621649945
TAX ID
TN
01
—
MD0000017178
STATE OF TN LICENSE
TN
Enumeration date
02/06/2007
Last updated
03/07/2023
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